Fungal keratitis

This is fungal infection of the cornea, a condition more common in warm wet climates, such as Florida, India and China. It is the leading cause of corneal blindness in some of these locations and is difficult to treat medically. In China, fungal pathogens were Fusarium (85.1%), Aspergillus (6.3%), Alternaria (4.6%), Penicillium (2.3%), and Candida (1.7%) Ophthalmology Zie et al. 2008. Corneal transplantation is often required, which may be either be a lamellar or penetrating procedure. Since Fusarium hyphae usually grow paralell to the corneal stromal lamellae and are the most common cause of fungal keratitis, lamellar keratoplasty can be a useful option in these patients, particularly as topical corticosteroids, required to prevent graft rejection, can increase the likelihood of reinfection of the graft. We usually desist from using topical steroids after keratoplasty for fungal keratitis for at least 2 weeks following the graft, to be sure that reinfection is unlikely. In contrast, most aspergillus hyphae grow vertically towards Descemet’s membrane and can subsequently perforate the anterior chamber. These patients would probably benefit more from full thickness penetrating keratoplasty than the partial thickness lamellar graft.